Prevalence of Chronic Hepatitis B and Incidence of Acute Hepatitis B Infection in Human Immunodeficiency Virus–Infected Subjects

Scott E. Kellerman, Debra L. Hanson, A. D. McNaghten, Patricia L. Fleming
2003 Journal of Infectious Diseases  
We determined incidence and risk factors for acute and chronic hepatitis B virus (HBV) infection and HBV vaccination rates among human immunodeficiency virus (HIV)-infected subjects from the Adult/Adolescent Spectrum of HIV Disease Project, during 1998-2001. Among 16,248 HIV-infected patients receiving care, the incidence of acute HBV was 12.2 cases/1000 person-years (316 cases), was higher among black subjects (rate ratio [RR], 1.4; 95% confidence interval [CI], 1.0-2.0), subjects with
more » ... sm (RR, 1.7; 95% CI, 1.2-2.3), subjects who had recently injected drugs (RR, 1.6; 95% CI, 1.1-2.4), and subjects with a history of AIDSdefining conditions (RR, 1.5; 95% CI, 1.2-1.9) and was lower in those taking either antiretroviral therapy (ART) with lamivudine (RR, 0.5; 95% CI, 0.4-0.6), ART without lamivudine (RR, 0.5; 95% CI, 0.3-0.7), or у1 dose of HBV vaccine (14% of subjects) (RR, 0.6; 95% CI, 0.4-0.9). Prevalence of chronic HBV was 7.6% among unvaccinated subjects. HBV rates in this population were much higher than those in the general population, and vaccination levels were low. HBV remains an important cause of comorbidity in HIV-infected persons, but ART and vaccination are associated with decreased disease. Persons at risk for infection with human immunodeficiency virus (HIV), through high-risk sexual and drugusing behaviors, are at higher risk for acute and chronic hepatitis B virus (HBV) infection. Previous studies have shown high prevalence of acute and chronic HBV infection in subjects at risk for HIV [1] [2] [3] [4] . In addition, persons with HIV infection are at higher risk for HBVrelated cirrhosis than are HBV-infected persons without HIV infection, and coinfection with both viruses has been shown to decrease survival time [5] . Although estimates of HBV prevalence [6] (0.4%) and incidence [7] (0.033 cases /1000 person-years [PY]) in the general US population are available, similar data
doi:10.1086/377135 pmid:12898445 fatcat:r5xfteznsjchbb6xixto6okaxy